Provider Demographics
NPI:1003241415
Name:MCGEEHAN, CAROLINE ROSE (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ROSE
Last Name:MCGEEHAN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 WARD TER
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-1743
Mailing Address - Country:US
Mailing Address - Phone:859-912-3660
Mailing Address - Fax:
Practice Address - Street 1:6501 CHESAPEAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-1974
Practice Address - Country:US
Practice Address - Phone:859-912-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007057235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist